Alternative to CPAP for CSA!

[benedictc]

Hello everybody.  Did you know there is a solution available to Central Sleep Apnea sufferers that is an alternative to mask ventilation?  Avery Biomedical Devices manufactures a Diaphragm Pacemaker system.  This is an implanted phrenic nerve stimulator.  It consists of surgically implanted electrodes and receivers and an external transmitter which sends radio signals to the implants via flexible antennas that are secured over the receivers.

The transmitter generates a series of impulses which are sent by the antenna through the skin as a radio wave.  The receiver converts the radio waves to an electrical impulse which travels down the electrode to the phrenic nerve.  The nerve then sends these impulses to the diaphragm causing it to contract, and draw air in.  When the impulses stop, the diaphragm relaxes, and exhalation occurs.  These series of impulses are repeated cyclically, resulting in a natural breathing pattern.

This system is preferable to CPap or other mechanical ventilation for many reasons.  It uses negative pressure versus the forced positive pressure of MV; it is small, portable, and silent; it can significantly reduce upper airway infections; and it costs less than $1000 a year in disposable supplies.  Best of all, it has full US FDA Premarket Approval and is reimbursed by Medicare & most private and government insurance.  You can get more information about this system on Averybiomedical's website.

Have a great day!

[DeepBreathing]

G'ay benedictc. Welcome to Apnea Board.

For full disclosure, can you tell us your relationship to this company - are you associated with them, a happy customer or some other?

Looking briefly at the website and published papers, it seems this device is mainly for people with paralysed diaphragms typically as a result of spinal cord injury or other conditions. The information relating to central sleep apnea is extremely limited and vague, and I don't think there was much (if any) discussion of central apnea in the papers, none of which is newer than 2011.

I would take a LOT of convincing to get this type of device surgically installed with all the attendant risks when I have the option of a relatively low cost, proven and non-invasive option such as my ASV machine.

[benedictc]

Hi DeepBreathing, and thank you!

I work for the company, but I am passionate about our device as well.  Please forgive me if I have violated a rule with this post.  Not here to do any convincing, but rather to educate people as to what is available.  Was speaking with a gentleman today (CSA sufferer) who mentioned that it would be nice for the people on this board to hear about our device since it is (unfortunately) not very well known even though our company is been around since the 1980s.  We are a small company and we only manufacture this one device, thus it can be difficult to make our presence known.  While you are correct that our system is also very useful for those with high spinal cord injury, we have many CSA patients (who cannot tolerate mask ventilation) pacing successfully with our system.

I'd be happy to share some additional scientific research with you (beyond what is available on our website) if you would like to explore further.  Of course our device is not for everybody, but our system is currently being used successfully by other folks with CSA.  Any surgical procedure presents risks, but our system can be implanted via multiple minimally invasive surgical methods.

Thanks again for your interest and reply.  Please let me know if there is any additional information I can provide.

[Walla Walla]

I have a question about it. Do your CSA patients go through a third party sleep center to verify that the sleep apnea is in fact being treated?

[benedictc]

Some do!  Once our patients are implanted, some will have a sleep study (while pacing) while most will monitor 02 with non-invasive pulse oximetry during the night.

[Walla Walla]

I think I'd want to see a long term study done by a third party medical center confirming that it does treat sleep apnea. O2 levels aren't the only thing affected by sleep apnea.

[benedictc]

Of course there are other factors affected by Central Sleep Apnea.  Our Diaphragm Pacemaker patients work closely with their pulmonologist or sleep physician to determine the best course of action to take once they are implanted and using our system.

[ardenum]

There's no magic to this. It simply sends pulses to the diaphragm muscle much like the inspire2 sends pulses to the tongue/throat muscles. I'd also assume a prerequisite would be no obstructive events of any kind. I'd assume a diagnostic protocol similar to those with ondines syndrome.

What I'm wondering more about is combining inspire2 with a diaphragm pacemaker for a total OSA & CSA solution.

[Toushiro303]

Looks promising!

[WakeUpTime]

What I'm wondering more about is combining inspire2 with a diaphragm pacemaker for a total OSA & CSA solution.

Wow, that would indeed be a dream solution for those like me who have both OSA & CSA.  In the mean time, an ASV machine might be the only viable solution.  It makes me wonder how many previous significant sufferers of OSA and CSA have perished well before their time, only to be labeled with other chronic symptoms (heart and brain related).  

It's always good to hear about new solutions for sleep apnea.